Rule 59G-4.002, Provider Reimbursement Schedules and Billing Codes
| Fee Schedule | Effective Date |
|---|---|
| Assistive Care Services Fee Schedule |
Updated Fee Schedule
[
9.3 kB
]
2024Promulgated Fee Schedule [
10 kB
]
2023Promulgated Fee Schedule [
10 kB
]
July 2022 |
| Behavior Analysis Fee Schedule |
Updated Fee Schedule
[
440.5 kB
]
2024 Promulgated Fee Schedule [
50.6 kB
]
2023 |
| Behavioral Health Overlay Services Fee Schedule |
Updated Fee Schedule
[
349.9 kB
]
2024 Promulgated Fee Schedule [
29.5 kB
]
2023Promulgated Fee Schedule [
29.5 kB
]
July 2022 |
| Birth Center Fee Schedule |
Updated Fee Schedule
[
92.9 kB
]
2024 Updated XLS [ 
70.8 kB
]
2024Promulgated Fee Schedule [
94.8 kB
]
2023Promulgated XLS [
70.9 kB
]
2023Promulgated Fee Schedule [
92 kB
]
July 2022Promulgated XLS [
70.7 kB
]
July 2022 |
| Child Health Targeted Case Management Services Fee Schedule |
Updated Fee Schedule
[
423.8 kB
]
2024 Promulgated Fee Schedule [
107.6 kB
]
2023Promulgated Fee Schedule [
107.6 kB
]
July 2022 |
| Community-Based Substance Abuse County Match Fee Schedule |
Updated Fee Schedule
[
30.7 kB
]
2024 Promulgated Fee Schedule [
30.7 kB
]
2023 |
| Community Behavioral Health Services Fee Schedule |
Updated Fee Schedule
[
562.9 kB
]
2024 Updated XLS [
13.7 kB
]
2024Updated Fee Schedule [
626.1 kB
]
Effective 10/1/2023Updated XLS [
19.8 kB
]
Effective 10/1/2023Promulgated Fee Schedule [
181.5 kB
]
2023Promulgated XLS [
13.7 kB
]
2023Promulgated Fee Schedule [
560.9 kB
]
July 2022Promulgated XLS [
13.4 kB
]
July 2022 |
| County Health Department Certified Match Program Fee Schedule |
Updated Fee Schedule
[
82.9 kB
]
2024 Promulgated Fee Schedule [
82.9 kB
]
2023 |
| Dental General Fee Schedule |
Updated Fee Schedule
[
154.2 kB
]
2024 Updated XLS [
17 kB
]
2024Promulgated Fee Schedule [
149.1 kB
]
2023Promulgated XLS [
117 kB
]
2023Promulgated Fee Schedule [
145.7 kB
]
July 2022Promulgated XLS [
117.2 kB
]
July 2022 |
| Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients |
Updated Fee Schedule
[
722.3 kB
]
2024 Updated XLS [
134.6 kB
]
2024Updated Fee Schedule [
966.3 kB
]
Effective 10/1/2023Updated XLS [
133.8 kB
]
Effective 10/1/2023Promulgated Fee Schedule [
989.8 kB
]
2023Promulgated XLS [
133.3 kB
]
2023Promulgated Fee Schedule [
1.1 MB
]
2022Promulgated XLS [
128 kB
]
2022 |
| Early Intervention Services Fee Schedule |
Updated Fee Schedule
[
19.5 kB
]
2024 Promulgated Fee Schedule [
19.4 kB
]
2023Promulgated Fee Schedule [
94.4 kB
]
2022 |
| Hearing Services Fee Schedule |
Updated Fee Schedule
[
41.3 kB
]
2024 Updated XLS [
14 kB
]
2024Promulgated Fee Schedule [
38.8 kB
]
2023Promulgated XLS [
155.6 kB
]
2023Promulgated Fee Schedule [
42.1 kB
]
July 2022Promulgated XLS [
156.1 kB
]
July 2022 |
| Home Health Visit Services Fee Schedule |
Updated Fee Schedule
[
61.5 kB
]
2024 Promulgated Fee Schedule [
61.5 kB
]
2023Promulgated Fee Schedule [
61.5 kB
]
July 2022 |
| Independent Laboratory Fee Schedule |
Updated Fee Schedule
[
298.4 kB
]
2024 Updated XLS [
34.9 kB
]
2024Promulgated Fee Schedule [
427.4 kB
]
2023Promulgated XLS [
86 kB
]
2023Promulgated Fee Schedule [
378.2 kB
]
July 2022Promulgated XLS [
82.2 kB
]
July 2022 |
| Licensed Midwife Fee Schedule |
Updated Fee Schedule
[
68.7 kB
]
2024 Updated XLS [
12.6 kB
]
2024Promulgated Fee Schedule [
135.9 kB
]
2023Promulgated XLS [
113.6 kB
]
2023Promulgated Fee Schedule [
137.1 kB
]
July 2022Promulgated XLS [
113.5 kB
]
July 2022 |
| Medicaid Certified School Match Program Fee Schedule |
Updated Fee Schedule
[
133.5 kB
]
2024 Promulgated Fee Schedule [
133.2 kB
]
2023Promulgated Fee Schedule [
167.9 kB
]
2022 |
| Medical Foster Care Services Fee Schedule |
Updated Fee Schedule
[
9.9 kB
]
2024 Promulgated Fee Schedule [
9.8 kB
]
2023Promulgated Fee Schedule [
9.9 kB
]
July 2022 |
| Mental Health Targeted Case Management Services Fee Schedule |
Updated Fee Schedule
[
423.8 kB
]
2024 Promulgated Fee Schedule [
107.6 kB
]
2023Promulgated Fee Schedule [
107.6 kB
]
July 2022 |
| Occupational Therapy Services Fee Schedule |
Updated Fee Schedule
[
35.5 kB
]
2024 Promulgated Fee Schedule [
35.2 kB
]
2023Promulgated Fee Schedule [
43.2 kB
]
July 2022 |
| Personal Care Services Fee Schedule |
Updated Fee Schedule
[
51.9 kB
]
2024 Promulgated Fee Schedule [
51.9 kB
]
2023Promulgated Fee Schedule [
51.9 kB
]
July 2022 |
| Physical Therapy Services Fee Schedule |
Updated Fee Schedule
[
35.7 kB
]
2024 Promulgated Fee Schedule [
35.3 kB
]
2023Promulgated Fee Schedule [
42.9 kB
]
July 2022 |
| Physician Pediatric Surgery Fee Schedule |
Updated Fee Schedule
[
141.1 kB
]
2024 Updated XLS [
22.5 kB
]
2024Promulgated Fee Schedule [
146.4 kB
]
2023Promulgated XLS [
20.1 kB
]
2023Promulgated Fee Schedule [
146.2 kB
]
2022Promulgated XLS [
20.1 kB
]
2022 |
| Practitioner Fee Schedule |
Updated Fee Schedule
[
2.6 MB
]
2024 Updated XLS [
262.2 kB
]
2024Updated Fee Schedule [
1.1 MB
]
Effective 10/1/2023Updated XLS [
271.4 kB
]
Effective 10/1/2023Promulgated Fee Schedule [
3 MB
]
2023Promulgated XLS [
274.5 kB
]
2023Promulgated Fee Schedule [
904.5 kB
]
July 2022Promulgated XLS [
280.3 kB
]
July 2022 |
| Practitioner Laboratory Fee Schedule (Formerly titled Physician and Outpatient Laboratory Fee Schedule) |
Updated Fee Schedule
[
499.2 kB
]
2024 Updated XLS [
53.7 kB
]
2024Updated Fee Schedule 2023 [
537.2 kB
]
Effective 1/1/2023Updated XLS 2023 Effective [
53 kB
]
1/1/2023Promulgated Fee Schedule [
592.7 kB
]
July 2022Promulgated XLS [
114.4 kB
]
July 2022 |
| Prescribed Drugs Immunization Fee Schedule |
Updated Fee Schedule
[
263.9 kB
]
Effective 10/1/23 Updated XLS [
19.8 kB
]
Effective 10/1/23Promulgated Fee Schedule [
279.7 kB
]
2023Promulgated XLS [
20.1 kB
]
2023 |
| Prescribed Pediatric Extended Care Services Fee Schedule |
Updated Fee Schedule
[
67.1 kB
]
2024 Updated Fee Schedule [
67.2 kB
]
Effective 7/1/2023Promulgated Fee Schedule [
67.1 kB
]
Effective 1/1/2023Promulgated Fee Schedule [
67.2 kB
]
July 2022 |
| Private Duty Nursing Services Fee Schedule |
Updated Fee Schedule
[
63.3 kB
]
2024 Promulgated Fee Schedule [
63.3 kB
]
2023Promulgated Fee Schedule [
63.3 kB
]
July 2022 |
| Radiology Fee Schedule |
Updated Fee Schedule
[
339.5 kB
]
2024 Updated XLS [
39.7 kB
]
2024Promulgated Fee Schedule [
421.7 kB
]
2023Promulgated XLS [
39.8 kB
]
2023Promulgated Fee Schedule [
414.6 kB
]
July 2022Promulgated XLS [
114.6 kB
]
July 2022 |
| Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule |
Updated Fee Schedule
[
50 kB
]
2024 Updated XLS [
12.1 kB
]
2024Promulgated Fee Schedule [
50 kB
]
2023Promulgated XLS [
12.1 kB
]
2023 |
| Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule |
Updated Fee Schedule
[
47.5 kB
]
2024 Updated XLS [
12.2 kB
]
2024Promulgated Fee Schedule [
47.5 kB
]
2023Promulgated XLS [
12.2 kB
]
2023 |
| Respiratory Therapy Services |
Updated Fee Schedule
[
96 kB
]
2024 Promulgated Fee Schedule [
29.7 kB
]
2023Promulgated Fee Schedule [
100.5 kB
]
July 2022 |
| Specialized Therapeutic Services Fee Schedule |
Updated Fee Schedule
[
501.3 kB
]
2024 Promulgated Fee Schedule [
102.6 kB
]
2023Promulgated Fee Schedule [
103.8 kB
]
July 2022 |
| Speech-Language Pathology Services Fee Schedule |
Updated Fee Schedule
[
38.2 kB
]
2024 Promulgated Fee Schedule [
38.1 kB
]
2023Promulgated Fee Schedule [
39.1 kB
]
July 2022 |
| Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule |
Updated Fee Schedule
[
423.8 kB
]
2024 Promulgated Fee Schedule [
107.6 kB
]
2023Promulgated Fee Schedule [
107.6 kB
]
July 2022 |
| Transportation Services Fee Schedule |
Updated Fee Schedule
[
19.5 kB
]
2024 Promulgated Fee Schedule [
19.5 kB
]
2023Promulgated Fee Schedule [
19.5 kB
]
July 2022 |
| Visual Services Fee Schedule |
Updated Fee Schedule
[
39.5 kB
]
2024 Updated XLS [
13.4 kB
]
2024Promulgated Fee Schedule [
41.6 kB
]
2023Promulgated XLS [
115.1 kB
]
2023Promulgated Fee Schedule [
42.4 kB
]
July 2022Promulgated XLS [
116.3 kB
]
July 2022 |
| Billing Code | Effective Date |
|---|---|
| County Health Department Billing Codes |
Updated Billing Code
[
109.9 kB
]
2024 Promulgated Billing Code [
109.7 kB
]
2023 |
| Federally Qualified Health Center Billing Codes |
Updated Billing Code
[
111.1 kB
]
2024 Promulgated Billing Code [
111.2 kB
]
2023 |
| Hospice Services Billing Codes |
Updated Billing Code
[
109.2 kB
]
2024 Promulgated Billing Code [
109.8 kB
]
2023 |
| Hospital Outpatient Services Billing Codes |
Updated Billing Code
[
165.6 kB
]
2024 Promulgated Billing Code [
165.6 kB
]
2023 |
| Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes |
Updated Billing Code
[
9.3 kB
]
2024 Promulgated Billing Code [
8.9 kB
]
2023 |
| Nursing Facility Services Billing Codes |
Updated Billing Code
[
9.3 kB
]
2024 Promulgated Billing Code [
8.8 kB
]
2023 |
| Prescribed Drugs Physician Administered Billing Codes |
Promulgated Billing Code
[
311.6 kB
]
2023 Promulgated XLS [
29.3 kB
]
2023 |
| Rural Health Clinic Billing Codes |
Updated Billing Code
[
104.7 kB
]
2024 Promulgated Billing Code [
104.6 kB
]
2023 |
| Statewide Inpatient Psychiatric Program Services Billing Codes |
Updated Billing Code
[
62.2 kB
]
2024 Promulgated Billing Code [
9.3 kB
]
2023 |
